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Abstract

Rheumatoid arthritis is a systemic inflammatory autoimmune condition of unclear aetiology. Foot problems, including pain, deformity and functional limitation, are common amongst patients. Despite orthotic intervention being common in rheumatoid arthritis, there is reportedly limited and conflicting evidence for its effectiveness. The aim of this review is to identify and evaluate the evidence for the effectiveness of foot orthoses in the management of adult patients with rheumatoid arthritis. A systematic literature review was conducted to identify relevant literature pertaining to the use of orthoses in the management of the rheumatic foot. Fifteen articles, comprising both primary and secondary evidence, were identified that met the inclusion criteria. Their methodological quality varied, but was generally good. Most interventions described reported beneficial effects on pain and function, using pre- and post-intervention measures or through comparisons with placebos. There were few studies that directly compared the effectiveness of different foot orthoses interventions (such as hard, soft, semi-rigid) in the management of rheumatoid arthritis of the foot. Clinical recommendations are difficult to make without this comparative data. The most appropriate foot orthoses may also be dependent on the type and level of foot deformity present from rheumatoid arthritis. Further research is recommended to identify appropriate orthotic interventions for different clinical scenarios.

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